Pancreatic gross tumor volume contouring on computed tomography (CT) compared with magnetic resonance imaging (MRI): Results of an international contouring conference. Pract Radiat Oncol 2018;8(2):107-115
Date
02/11/2018Pubmed ID
29426692DOI
10.1016/j.prro.2017.11.005Scopus ID
2-s2.0-85043352148 (requires institutional sign-in at Scopus site) 17 CitationsAbstract
PURPOSE: Accurate identification of the gross tumor volume (GTV) in pancreatic adenocarcinoma is challenging. We sought to understand differences in GTV delineation using pancreatic computed tomography (CT) compared with magnetic resonance imaging (MRI).
METHODS AND MATERIALS: Twelve attending radiation oncologists were convened for an international contouring symposium. All participants had a clinical and research interest in pancreatic adenocarcinoma. CT and MRI scans from 3 pancreatic cases were used for contouring. CT and MRI GTVs were analyzed and compared. Interobserver variability was compared using Dice's similarity coefficient (DSC), Hausdorff distances, and Jaccard indices. Mann-Whitney tests were used to check for significant differences. Consensus contours on CT and MRI scans and constructed count maps were used to visualize the agreement. Agreement regarding the optimal method to determine GTV definition using MRI was reached.
RESULTS: Six contour sets (3 from CT and 3 from MRI) were obtained and compared for each observer, totaling 72 contour sets. The mean volume of contours on CT was significantly larger at 57.48 mL compared with a mean of 45.76 mL on MRI, P = .011. The standard deviation obtained from the CT contours was significantly larger than the standard deviation from the MRI contours (P = .027). The mean DSC was 0.73 for the CT and 0.72 for the MRI (P = .889). The conformity index measurement was similar for CT and MRI (P = .58). Count maps were created to highlight differences in the contours from CT and MRI.
CONCLUSIONS: Using MRI as a primary image set to define a pancreatic adenocarcinoma GTV resulted in smaller contours compared with CT. No differences in DSC or the conformity index were seen between MRI and CT. A stepwise method is recommended as an approach to contour a pancreatic GTV using MRI.
Author List
Hall WA, Heerkens HD, Paulson ES, Meijer GJ, Kotte AN, Knechtges P, Parikh PJ, Bassetti MF, Lee P, Aitken KL, Palta M, Myrehaug S, Koay EJ, Portelance L, Ben-Josef E, Erickson BAAuthors
Beth A. Erickson MD Professor in the Radiation Oncology department at Medical College of WisconsinWilliam Adrian Hall MD Professor in the Radiation Oncology department at Medical College of Wisconsin
Eric Paulson PhD Chief, Professor in the Radiation Oncology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AgedHumans
Magnetic Resonance Imaging
Male
Pancreatic Neoplasms
Tomography, X-Ray Computed